...process in improving patient care and safety during hospitalization. Medication-related errors are serious and occur at a rate of about one per patient per day (Allan, 1990). It is a harmful practice affecting patient’s health and life. Some of these errors may result in death or inefficiency of organs functions. In addition, medication errors may financially affect the health care organization due to long patient stay in the hospital for advanced treatment (Presto, 2004). This research paper will provide highlights on medication errors definition, importance of safety during medication process, factors contributing to medication errors and effective factors in preventing medication errors. Medication errors were defined as a fault in medication that may occur at any stage of the process in ordering or delivering medications (Bates, Boyle, Vliet, Scheider & Leape, 1995), either an injury occurred or the potential for injury was present (Bates et al, 1999). These errors could occur in dosing error, which is common (Lesar, Briceland & Stein, 1997), or wrong route, or wrong time, or error in medicine rate and omission error (O’Shea, 1998). Also there are some situations such as missing a dose of medication or the correct medication given too many times to the patient. Both of these situations are considered as medication error (Bates, Boyle, Vliet, Schneider & Leape, 1995). These errors can happen anywhere, it can occur at home, pharmacies and hospitals or doctor’s clinics...
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...The Advantages of Medicating Children with ADHD The Advantages of Medicating Children with ADHD The educational effect of medicating a child who has been correctly identified with attention-deficient hyperactive disorder (ADHD) far supersedes the adverse affects of the drugs being prescribed. In understanding that each child is different in their way and usually exerts an abundance of energy compared to adults is not a qualifying factor in being ADHD. Children who have not yet began school in a controlled and structured environment cannot be assessed by physicians with accuracy. Teachers play their most crucial role before any diagnosis is actually made by the family physician, psychiatrist, or pediatrician. According to Weber et al. (1992), children who are suspected of having ADHD are initially identified because of their behavioral and academic performance in the classroom. Studies conducted in schools repeatedly report the same sequence of events for many children referred for suspected ADHD. Teachers become aware of the students' difficulty in meeting the behavioral, attention, and academic norms for the class and suggest the possibility of ADHD to parents. Students who are constantly being placed in time-out, reprimanded, and conference cannot learn when all of the teacher’s attention is placed on behavior instead of academics. As a result of proper medical evaluation and teacher questionnaires, a student who is diagnosed with ADHD could build a successful foundation...
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...From Medscape Nurses Medication Error Prevention for Healthcare Providers Faculty and Disclosures CE Information There are between 44,000 and 98,000 individuals who die every year in hospitals due to preventable medical errors.[1] It has also been reported that this is only part of the problem, as thousands of other patients are adversely affected by medical errors or barely avoid injuries that are nonfatal.[2] These medical errors not only cost the loss of lives, but carry a financial burden that is estimated to be in a range of $17 billion to $29 billion annually. Additionally, there is physical and psychological pain and suffering related to these errors.[1] Another consequence is that medical errors diminish trust and satisfaction in the healthcare system and in healthcare professionals.[1] Ginette A. Pepper, PhD, RN, FAAN, a Professor and Helen Lowe Bamberger Colby Presidential Endowed Chair and Associate Dean for Research, University of Utah College of Nursing, Salt Lake City, spoke on medication safety for the geriatric nurse practitioner (GNP).[3] Dr. Pepper was trained as a pharmacologist with a nursing focus. She was one of the first NPs to add "geriatric" to her title as well as one of the first NPs to have prescriptive authority. Safety Principles and the Medication Use Process Dr. Pepper noted that safety issues are of the utmost importance for all healthcare providers.[3] Nursing as a profession has a long history of regarding patient safety as a primary...
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...past data indicates it has not always been so. The Institute of Medicine determined in the late 1990’s that 44,000 to 98,000 patients die from medical mistakes each year (Wachter, 2008). This tremendous number of deaths places medical care mishaps between the fifth and eighth leading causes of deaths in the United States (Kizer, 2001). In 2002, The Joint Commission established National Patient Safety Goals (NPSG) to help accredited organizations with patient safety in specific areas. An advisory group comprised of nurses, physicians, pharmacists, risk managers, clinical engineers, and others with appropriate experience advises The Joint Commission on how to address emerging patient safety issues. This group also periodically develops and updates the goals. The goals are grouped into broad categories and for 2011-2012, cover such categories as patient identification, health care-associated infections, improving communication, medication safety, reducing falls, and risk assessment. A discussion of selected elements underlying the current NPSG such as hand washing techniques, training, and lack of communication between healthcare personnel that can lead to medication errors, to falls, and even death, plus other related factors such as staffing shortages, problems with using outdated equipment, considerations in using the electronic medical records, and compliance with statutes provide insight into the challenges faced by today’s healthcare institutions and providers. Healthcare...
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...Accreditation Audit AFT2 Task 1 Executive Summary Current Compliance Status A. Compliance Status – Executive Summary Nightingale Community Hospital’s is a healthcare facility with a vision to” be the hospital of choice for patients, employees, physicians, volunteers, and the community.” We also state our mission is to create a healing environment, with a passionate commitment to healthcare excellence. Creating this vision and staying true to the stated mission requires that we adhere to the requirements set forth by the Joint Commission. In preparing for the Joint Commission visit there are focus priority areas that will need to be addressed if Nightingale is going to be compliant. The specific focus area addressed in this summary is medication management. There are three standards that come under the medication management area. The standards are listed in the table below along with their descriptions and summary of whether Nightingale Hospital has the documentation/data to be Joint Commission compliant for the given standard. Standard | Description | Joint Commission Compliance | MM.01.01.01 | The hospital plans its medication management processes. | MetNightingale PoliciesPatient Care Polices: 1. Medication Management, Patient Specific Information 2. Medication Administration | NPSG.03.04.01 | Label all medications, medication containers (for example, syringes, medicine cups, basins), or other solutions on and off the sterile field. | MetNightingale Hospital...
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...Anita Marban University of Maryland The Benefits and Challenges of Computerized Physician Order Entry (CPOE): How are physicians affecting implementation? Executive Summary: Physicians have always been the driving force behind the success of new technologies and their effects on healthcare. They are interested in new ways of providing care by utilizing medications or trying new procedures and medical devices. Through research they seek to understand the human body and find cures for the diseases that attack it. They spend years in school and incur debt in upwards of $200,000 dollars before they graduate and have the opportunity to practice independently. Confronted with technology that can improve patient safety by up to 95% and save billions of dollars, they resist change. In the U.S. less than 10% of hospitals and less that 25% of physician offices have fully functioning CPOE systems. Cedars Mt Sinai pulled the plug on their multi-million dollar CPOE system, as did 6 other hospitals because physicians refused to use them. A review of the literature shows that approximately 68% of physicians surveyed identify CPOE as the solution to preventing many medical errors, adopting best-clinical-practices and reducing healthcare costs by billions of dollars annually. It also shows that physicians have issues and concerns with adopting CPOE and until hospitals and government regulatory bodies are ready to, not only address, but solve them, CPOE has little chance...
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...SCHOOL OF PHARMACY REPORT WRITING UCS 1263 Assignment 1 Hospital Attachment Report Name : Thiban Ellumalay ID : 012011051056 Programme : BPH Lecturer Name : Dr. Jiyauddin Khan Submission Date : 30th September 2013 An attachment report based on the lesson learned, activity being carried out, experience gained, problem faced and suggestion at Hospital Tuanku Ampuan Rahimah, Klang in various pharmacy departments for period of 3 weeks Submitted to Dr. Jiyauddin Khan, PhD Report writing lecturer, School of Pharmacy Management & Science University Shah Alam, Selangor Darul Ehsan, Malaysia. Prepared by, Thiban Ellumalay, 012011051056 3rd year Bachelor of Pharmacy, Management & Science University Shah Alam, Selangor Darul Ehsan, Malaysia. 30th September 2013 Acknowledgement First and foremost I would like to thank the almighty lord for giving me wisdom to get my attachment done with successfully as well as with the preparation of the report. Without his blessings I wouldn’t have achieved this stage. Besides that, throughout my attachment accomplishment, many people have inspired me, influenced me and contributed their time, energy, ideas, and suggestions for improving my report. I will always be in debt to these people, too numerous to mention. I would...
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...is overweight or reach obesity. Also, too high or too low level of blood pressure and glucose level cause abnormal in the person. For all of these reasons, the research was conducted to interrogate student’s academic performance based on their level of health. 1.2 Problem Statement It seems that very rare people do the research concerning about the health issues and student’s academic performance. Therefore researcher decides to look further into this matter so that it can be confirmed that there is relationship in health issue with academic performance. According to one study made by (Steven R. Shaw, 2015), children who experience medical distress are at risk for low academic achievement. Among other factors that limit student’s abilities to engage in the education process is discomfort or pain, movement limitations, sleepiness, physical and psychological side-effect of received medications (Steven R. Shaw, 2015). Besides that, researcher knows that having a high glucose level can cause sick to stomach, faint or throw up. It also cause lost of too much fluid from body. Meanwhile, having a low glucose level can cause a low blood sugar reaction called hypoglycaemia. All of this might happen if students under stress, having an infection or missing a meal (MD, 2018). It can also cause diabetes that clearly related to lifestyle, especially unsuitable food consumption and low body activity. (Seyed Amir Hossein Zehni Moghadam, 2016). Hence, it is because of there is an issue of health...
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...Shirley Murphy, MD, and Rosemary Roberts, MD Silver Spring, Md A prominently displayed boxed warning, the so-called ‘‘black box,’’ is added to the labeling of drugs or drug products by the Food and Drug Administration when serious adverse reactions or special problems occur, particularly those that may lead to death or serious injury. Healthcare providers are often not knowledgeable about the origin, meaning, and implications of these ‘‘black box’’ warnings. In this review, our goal is to provide insight into how the Food and Drug Administration evaluates, communicates, and manages drug benefit/risk. We discuss drug labeling, the emphasis on safety throughout the drug approval process, legislative initiatives for safe use of drugs in children, and postmarketing safety surveillance. In addition, we encourage health care providers to report drug reactions to the Food and Drug Administration’s MedWatch program. A discussion of new Food and Drug Administration initiatives to improve drug safety processes and methods to serve the public better are highlighted. (J Allergy Clin Immunol 2006;117:34-9.) Key words: Food and Drug Administration, adverse drug reactions, MedWatch, ‘‘black box’’ warning, drug labeling, drug benefit/risk, risk management, postmarketing surveillance, drug development Abbreviations used AERS: Adverse Event Reporting System CDER: Center for Drug Evaluation and Research CFR: Code of Federal Regulations DSOB: Drug Safety Oversight Board FDA: US Food and Drug...
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...the urea cycle. Sources of ammonia include bacterial hydrolysis of urea and other nitrogenous compounds in the intestine, the purine-nucleotide cycle and amino acid transamination in skeletal muscle, and other metabolic processes in the kidneys and liver. Increased entry of ammonia to the brain is a primary cause of neurological disorders associated with hyperammonemia, such as congenital deficiencies of urea cycle enzymes, hepatic encephalopathies, Reye syndrome, several other metabolic disorders, and some toxic encephalopathies. Ammonia is a productof the metabolismof proteinsand other compounds,and itis required for the synthesis of essential cellular compounds. However,a 5- to 10-fold increase in ammonia in the blood induces toxic effects in mostanimal species, withalterations in the functionof the central nervous system. Bothacuteand chronic hyperammonemia result inalterationsof the neurotransmitter system. Based onanimal study findings, the mechanismofammonia neurotoxicityat the molecular level has been proposed.Acuteammonia intoxication inananimal model leads to increased extracellular concentrationof glutamate in the brainand results inactivationof the N-methyl D-aspartate (NMDA) receptor.Activationof this receptor mediatesATP depletionandammonia toxicity; sustained blockingof the NMDA receptor by continuousadministrationofantagonists dizocilpine (MK-801) or memantine prevents both phenomena, leading to significantly increased survival time in rats.[1] TheATP depletionis...
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...http://www.nap.edu/catalog/9728.html We ship printed books within 1 business day; personal PDFs are available immediately. To Err Is Human: Building a Safer Health System Linda T. Kohn, Janet M. Corrigan, and Molla S. Donaldson, Editors; Committee on Quality of Health Care in America, Institute of Medicine ISBN: 0-309-51563-7, 312 pages, 6 x 9, (2000) This PDF is available from the National Academies Press at: http://www.nap.edu/catalog/9728.html Visit the National Academies Press online, the authoritative source for all books from the National Academy of Sciences, the National Academy of Engineering, the Institute of Medicine, and the National Research Council: • Download hundreds of free books in PDF • Read thousands of books online for free • Explore our innovative research tools – try the “Research Dashboard” now! • Sign up to be notified when new books are published • Purchase printed books and selected PDF files Thank you for downloading this PDF. If you have comments, questions or just want more information about the books published by the National Academies Press, you may contact our customer service department tollfree at 888-624-8373, visit us online, or send an email to feedback@nap.edu. This book plus thousands more are available at http://www.nap.edu. Copyright © National Academy of Sciences. All rights reserved. Unless otherwise indicated, all materials in this PDF File are copyrighted by the National Academy of Sciences. Distribution, posting, or copying...
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...WRITING AN EFFECTIVE RESEARCH PROPOSAL The purpose of this handout is not to teach you how to design a research project. Rather it is to help you translate your research plans into an effective research proposal. A well-written proposal will ease the process of obtaining institutional and ethical approval and will increase your chances of obtaining funding for your project. The writing of this booklet was guided by our experience writing proposals but also on our experiences as reviewers on institutional and granting agency review panels. The booklet is designed for health sciences researchers conducting quantitative, clinical research. However, the general concepts are applicable to most areas of inquiry. Writing an Effective Research Proposal 2 ELEMENTS OF A RESEARCH PROPOSAL ∗ ∗ ∗ ∗ ∗ ∗ ∗ Title Abstract Study Problem Rationale/Relevance of the Project Literature Review Specific Study Objectives Research Methods I. Study design II. Subjects Inclusion/exclusion criteria Sampling Recruitment plans Method of assignment to study groups III. Data collection Variables: outcomes, predictors, confounders Measures/instruments Procedures IV. Intervention V. Statistical considerations Sample size Data analysis Ethical Considerations Consent form Privacy of information Work Plan Budget Research team Dissemination Plan 3 ∗ ∗ ∗ ∗ ∗ Writing an Effective Research Proposal KEYS TO SUCCESS TO WRITING A GOOD PROPOSAL Overall Quality of the Study ∗ Good research question...
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...MBA Consulting Project Customer Loyalty as a Function of Brand Penetration Growth Arguably, generating customer loyalty is a prerequisite for effective ad campaigns. Frederick Reichheld claimed in the 1980s that by increasing customer retention by 5%, profitability would increase from 25% to 85%. Since then, profitability has actually increased 25% to 100%. Subaru used a multi-platform marketing campaign which included online and offline elements as well as a customer relationship management scheme, with personalized direct communications According to Andrew Ehrenberg's "double jeopardy rule", small brands are said to be "doubly jeopardized" because they have fewer buyers who are less loyal to the brand, while large brands tend to "benefit twice" as a result of higher market penetration, increased buying frequency and customer loyalty. Brands looking to increase customer loyalty should focus on increasing penetration, since loyalty follows as a logical consequence of brand penetration ." Consumer loyalty can also be increased by creative marketing campaigns that generate buzz and stimulate word-of-mouth. As opposed to simply looking at attitudinal loyalty, it is important to observe price sensitivity as a measure of consumer commitment to a brand. Multi-media campaigns are an effective way to stimulate market share, thereby increasing brand loyalty. An important part of any marketing mix is the use of television advertising, which repeatedly demonstrates it's superiority...
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...History • Personal and Social History • Review of Systems • Physical Exam • QuEST/SCHOLAR-MAC Introduction The patient interview is the primary way of obtaining comprehensive information about the patient in order to provide effective patient-centered care, and the medication history component is the pharmacist’s expertise. A methodological approach is used to obtain information from the patient, usually starting with determining the patient’s chief complaint, also known as the reason for the healthcare visit, and then 2 Chapter 1 / The Patient Interview delving further into an exploration of the patient’s specific complaint and problem. A comprehensive patient interview includes inquiring about the patient’s medical, medication, social, personal, and family history, as well as a thorough review of systems and possibly a physical examination. The medication history is the part of the patient interview that provides the pharmacist the opportunity to utilize his or her expertise by precisely collecting each component of the medication history (however, a medication history may also be...
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...Applied Statistical Methods Larry Winner Department of Statistics University of Florida February 23, 2009 2 Contents 1 Introduction 1.1 Populations and Samples . . . . . . . . . . . 1.2 Types of Variables . . . . . . . . . . . . . . . 1.2.1 Quantitative vs Qualitative Variables 1.2.2 Dependent vs Independent Variables . 1.3 Parameters and Statistics . . . . . . . . . . . 1.4 Graphical Techniques . . . . . . . . . . . . . 1.5 Basic Probability . . . . . . . . . . . . . . . . 1.5.1 Diagnostic Tests . . . . . . . . . . . . 1.6 Exercises . . . . . . . . . . . . . . . . . . . . 7 7 8 8 9 10 12 16 20 21 25 25 29 29 29 32 32 32 32 32 35 35 37 38 38 39 40 42 42 44 48 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 Random Variables and Probability Distributions 2.1 The Normal Distribution . . . . . . . . . . . . . . . . . . 2.1.1 Statistical Models . . . . . . . . . . . . . . . . . 2.2 Sampling Distributions and the Central Limit Theorem 2.2.1 Distribution of Y . . . . . . . . . . . . . . . . . . 2.3 Other Commonly Used Sampling Distributions . . . . . 2.3.1 Student’s...
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